肘关节外侧小切口治疗儿童肱骨髁上严重骨折疗效观察

Clinical observation on the treatment of mini-incision outside the elbow joint for children with severe humerus supracondylar fracture

目的探讨儿童肱骨髁上严重骨折实施肘关节外侧小切口手术的临床价值。方法选择2012年1月至2015年1月湖南省儿童医院骨科收治肱骨髁上严重骨折患儿38例为研究对象,所有患儿均接受肘外侧小切口手术治疗与克氏针内固定,术后1～2年随访调查,采取Flynn标准评估疗效。结果 38例患儿均顺利接受手术治疗,术后切口一期愈合,肘功能良好恢复,平均骨性愈合时间(2.7±0.4)个月。术后跟踪随访,优、良、可、差依次为26例、8例、3例和1例,总优良率为89.47%(34/38)。围术期及随访期间无一例发生松动、神经性血管受损及肘内翻等问题。结论对肱骨髁上严重骨折患儿行肘外侧小切口入路,手术优良率高、安全性好,且具有微创、操作简便、费用低等特点,可作为今后临床治疗肱骨髁上骨折的一种推荐手术方案。

Objective To observe the clinical value of the mini-incision outside the elbow joint for children with severe humerus supracondylar fracture.Methods Totally 38 cases of severe humerus supracondylar fracture were chosen at the Hunan Children＇s Hospital between January 2012 and January 2015.The children underwent surgical treatment with mini-incision outside the elbow and fixation with Kirschner wire.The efficacy was assessed by the Flynn standard during the 1 to 2-year follow-up.Results The surgeries for children were all successful and the incision wound healed smoothly.The elbow function recovered well with an average bone healing time of（2.7±0.4）months.The total percentage of patients rated as excellent（26 cases）and good（8 cases）was 89.47%（34/38）,and the other patients were rated as not good（3 cases）and bad（1 case）.During the perioperative period and follow-up,no patient had elbow loosening,neurological vascular damage or cubitus varus.Conclusion The mini-incision outside the elbow joint should be recommended as a surgical procedure for children with severe humerus supracondylar fracture,due to its good safety,minor wound,simple operation and low expense.